Doctors on Call – Allergies & Skin Problems
02
February

By Adem Lewis / in , , , /


♪>>IT EVENING AND WELCOME TO DOCTORS ON CALL. I’M A PEDIATRICIAN AND CHIEF MEDICAL OFFICER WITH A CENSURE HEALTH. I’M THE HOST FOR OUR PROGRAM TONIGHT ON ALLERGY AND SKIN PROGRAMS. PLEASE CALL IN YOUR QUESTIONS ON ANY ALLERGY OR SKIN RELATED PROBLEMS AND WE WILL DO OUR BEST TO ANSWER THEM. THE TELEPHONE NUMBERS FOR YOUR QUESTIONS CAN BE FOUND AT THE BOTTOM OF YOUR SCREEN. OUR MEDICAL STUDENTS ANSWERING PHONES TONIGHT ARE CASSANDRA FROM JUNEAU, LAURA OF BECKERMAN, AND MARA FROM WATCH REST ARE. NOW TO OUR PROGRAM ON ALLERGIES AND SKIN CONDITIONS. HOW WAS THE DRIVE UP THIS EVENING?>>UNEVENTFUL, FORTUNATELY.>>PROBABLY NOT TOO BAD FROM ST. LOUIS.>>IT’S NOT FAR TO DRIVE.>>HOW LONG HAVE YOU BEEN IN PRACTICE?>>SINCE 1990.>>SEVEN YEARS?>>YES. SINCE RESIDENCY.>>I’VE BEEN IN BUSINESS FOR 33 YEARS NOW.>>I HAVE A Q QUESTIONS TO GET US STARTED. THIS QUESTION IS, HOW CAN I PROTECT MY SKIN FROM SCOTT — SUN DAMAGE? IS THERE A WAY TO TAN SAFELY?>>THERE ARE SEVERAL THINGS YOU CAN THINK OF. DON’T GO OUT WHEN THE SUN IS VERY HIGH IN THE SKY. AVOIDING A LOT OF OUTDOOR ACTIVITIES IN THE PEAK SUN HOURS, FROM 11:00 TO 3:00 OR THEREABOUTS. WEARING SUNSCREEN. SPF HIGH, 30 OR ABOVE. PUTTING IT ON FREQUENTLY. I PUT IT ON IN THE MORNING AND I’M FINAL DAY JUST DOESN’T WORK. YOU HAVE TO KEEP IT IN YOUR POCKET OR SOMEWHERE WHERE YOU CAN PUT IT ON EVERY COUPLE OF HOURS OR YOU ARE NOT HELPING YOURSELF. THERE’S ALSO SOME PROTECTIVE CLOTHING THAT IS VERY USEFUL. YOU CAN PUT THAT ON IN THE MORNING AND LEAVE IT ON ALL DAY AND YOU ARE FINE. THAT CAN REALLY HELP. A HAT WITH A WIDE BRIM. SUNGLASSES HELP. YOU HAVE TO REMEMBER THAT YOU GET REFLECTIVE SUNLIGHT IF YOU ARE ON THE WATER OR THE SNOW. THERE IS SUNLIGHT BOUNCING UP. EVEN IF YOU HAVE A HAT ON, YOU CANNOT SAY, I’M FINE.>>THANK YOU.>>TANNING SAFELY, CHEMICALLY. NOTHING TO DO WITH UV RAYS OR TANNING BEDS OR ANYTHING LIKE THAT.>>THANK YOU. WHEN SHOULD I HAVE A MOLE CHECKED OUT?>>I THINK THAT’S A VERY IMPORTANT QUESTION. IT GETS TO THE HEART OF ONE OF THE MOST IMPORTANT THINGS WE DO IS DERMATOLOGIST WHICH IS DETECT AND TREAT MELANOMA. THAT IS ONE OF THE MOST DEADLY FORMS OF CANCER, NOT JUST SKIN CANCER. WE HAVE THE ABCD E RULE. A FOR ASYMMETRY. ONE SIDE OF THE MALL DOESN’T LOOK LIKE THE OTHER SIDE. BEFORE BORDER IRREGULARITY. THE EDGE OF THE MALL IS ILL-DEFINED. SEE FOR COLOR VARIATION. MEANING MORE THAN ONE SHADE OF COLOR. COLORS YOU DON’T EXPECT TO SEE IN MOLES. D IS FOR DIAMETER LARGER THAN A PENCIL ERASER. I LIKE TO THROW IN THE FOR EVOLUTION OR CHANGE. DON’T ASSUME THAT BECAUSE IT HAS BEEN THERE FOREVER, IT IS FINE. 50% OF MELANOMA ARISE FROM EXISTING MOLES. THE OTHER 50% WILL ARISE FROM SKIN THAT USED TO LOOK COMPLETELY NORMAL. THE CAVEAT HERE IS THAT IT’S NORMAL TO CONTINUE GETTING NEW MOLES. WE ARE NOT BORN WITH ALL OF THEM. WE GET THEM THROUGHOUT HER CHILDHOOD YEARS. AROUND 35 YEARS OF AGE, WE SHOULD STOP MAKING NEW MOLES. IF YOU ARE 65, 70 AND YOU SEE A NEW MALL, GET THAT CHECKED EVEN IF IT DOESN’T SEEM TO VIOLATE THOSE RULES I JUST LAID OUT.>>THANK YOU. IS THERE A WAY TO TREAT NAIL FUNGAL INFECTION?>>WE HAVE WAYS TO TREAT IT. NAIL FUNGAL INFECTION IS USUALLY CAUSED BY AN ORGANISM THAT PENETRATES INTO THE NAIL AND CAUSES YELLOWISH DISCOLORATION, SOMETIMES IT WILL CAUSE SEPARATION OF THE NAIL. WAYS WE CAN TREAT THAT. WE’VE TRIED TOPICAL THERAPIES OVER THE YEARS. AT BEST, ONE OUT OF 10 PATIENTS RESPOND TO TOPICAL THERAPY. IF THERE’S ONLY AN INDIVIDUAL MALE INVOLVED, WE COULD SURGICALLY REMOVE THAT AND TREATED WITH TOPICAL ANTIFUNGAL’S. MOST EFFECTIVE TREATMENT FOR NAIL FUNGUS WOULD BE TO USE A MEDICATION. IF YOU TAKE IT BY MOUTH DAILY, FOR 90 DAYS, PERHAPS TWO OUT OF THREE PATIENTS MIGHT BE ABLE TO CLEAR THEIR FUNGAL INFECTION. THE FUNGAL INFECTION, YOU ARE NOT PROTECTED FROM IT FOREVER. WHAT HAPPENS IS, WHEN YOU TAKE MEDICINE, IT GETS INCORPORATED INTO THE NAIL PLATE. AS THE NAIL GROWS OUT, THE FUNGAL INFECTION CAN A LONGER PENETRATE THAT NAIL. YOU TRIM AWAY THE DISEASED PORTION OF THE NAIL. TOENAILS TAKE ABOUT A YEAR TO GROW OUT. YOU CAN TAKE THE PILLS FOR THREE MONTHS BUT YOU MIGHT NOT SEE THE FUNGAL INFECTION CLEAR UNTIL THE FOLLOWING YEAR. A YEAR DOWN THE PIKE, THAT MEDICINE IS NO LONGER GOING TO BE IN THE NAIL ANYMORE. THEY CALL THIS THE FUNGUS AMONG US. THE NAIL CAN BECOME REAL FUNK AT — REINFECTED. NOT ALL TOENAIL ABNORMALITIES ARE DUE TO FUNGAL INFECTIONS. YOU WANT TO HAVE A PROPER DIAGNOSIS BEFORE YOU START TAKING MEDICATION LIKE THAT.>>THANK YOU. THIS QUESTION IS FROM JOHN IN SEVEN. CAN SOMEONE DEVELOP NEW ALLERGIES? HOW DO YOU TEST FOR ALLERGIES?>>PEOPLE CAN DEFINITELY DEVELOP NEW ALLERGIES. YOU DEVELOP ALLERGIES FROM BEING EXPOSED TO SOMETHING. GENERALLY IT TAKES A TIME OR TWO. EVEN IF YOU DIDN’T USED TO BE ALLERGIC TO SOMETHING, YOU CAN BECOME ALLERGIC TO IT. SOMETIMES IT IS OBVIOUS. YOU EAT SOMETHING OR PUT SOMETHING ON YOUR SKIN AND ALL OF A SUDDEN, THERE’S A REACTION. THAT’S A GOOD TEST RIGHT THERE. IF YOU ARE NOT SURE WHAT YOU ARE ALLERGIC TO, THERE ARE SOME BLOOD TEST. THERE ARE SOME DERMATOLOGIC TESTS THAT CAN BE DONE TO DETERMINE WHAT YOU ARE ALLERGIC TO. THERE ARE SOME LIMITATIONS. YOU CAN’T JUST SAY, I’M GOING TO HAVE ATTESTED IT WILL TELL ME WHAT I’M ALLERGIC TO. IT IS A SPECIFIC — WE WILL GIVE YOU AN EXPOSURE TO SAY, IN MY ALLERGIC TO PEANUTS, EGG WHITES, BIRCH TREES. IT IS A YES OR NO QUESTION. YOU CAN’T ASK THAT TO US EVERY — EVERY SINGLE ENERGY UNDER THE SUN.>>HERE’S A QUESTION FROM DULUTH. LITTLE RED DOTS ON SKIN SURFACE. STOMACH AND THIGHS. SIZE OF THE TIP OF A FINE PEN. WHAT COULD IT BE? IT IS NOT RAISED OR ITCHY.>>THAT DOESN’T GIVE YOU A LOT OF INFORMATION.>>DERMATOLOGY IS A VISUAL FIELD. IT CAN BE DIFFICULT. I HAD A PRECEPTOR DURING MY TRAINING WHO USED TO SAY, BE AWARE OF THE LITTLE PINK.. WE ASCRIBE THEM TO A BENIGN VASCULAR PROLIFERATION CALLED A CHERRY ANGIOMA. BUT THEY CAN ALSO BE A MARKER FOR DAMAGE TO BLOOD VESSELS IN THE SCAN. SOMETHING CALLED VASCULITIS. THEY CAN BE A MARKER FOR BLEEDING TENDENCIES IN THE FORM OF LOW PLATELET COUNTS. SO I TELL THIS CALLER, IF THEY HAVE CONCERNS REGARDING THESE SPOTS, ESPECIALLY IF THEY ARE BECOMING MORE NUMEROUS OR ANYTHING ELSE SEEMS OUT OF THE ORDINARY, THEY SHOULD GET THEIR SKIN TECH — CHECK.>>THANK YOU VERY MUCH. HERE’S AN APPROPRIATE QUESTION FOR YOU. I’M AWARE OF WHAT YOU DO WHEN YOUR WORK. ZACH WANTS TO KNOW, WHAT IS MOST PROCEDURE — MOST PROCEDURE?>>THE MO PROCEDURE IS A WAY TO TREAT SKIN CANCER. MOST OFTEN WE ARE TREATING NONMELANOMA SKIN CANCER WITH THIS TECHNIQUE. IT STANDS FOR MICRO GRAPHIC CONTROL OF THE MARGINS. WE TAKE THE SKIN CANCER OUT. WE TAKE A SKIN CANCER OUT LAYER BY LAYER. WE PROCESS THE TISSUE, WE ARE ABLE TO LAY IT OUT AND DRAW A THREE-DIMENSIONAL MAP SO WE CAN FOLLOW THE TUMOR LEFT OR RIGHT, UP OR DOWN. THE MO TECHNIQUE GENERALLY CAN GET A 99% CURE RATE. THAT IS THE MO PROCEDURE. WE ARE ABLE TO GET THE HIGHEST CURE RATE AND CONSERVE AS MUCH NORMAL SKIN AS POSSIBLE. IF WE CAN KEEP THE WIND SMALLER, IT IS EASIER TO REPAIR THE WOUND WITH PLASTIC SURGERY TECHNIQUES.>>HOW DO YOU TREAT ALLERGIES? WHAT ARE THE TREATMENTS FOR ALLERGIES?>>THERE ARE SEVERAL DIFFERENT TREATMENTS FOR ALLERGIES. IT’S POSSIBLE TO REMOVE THE ALLERGEN FROM YOUR ENVIRONMENT, THAT IS THE EASIEST. TARGETING THE MAJOR SYMPTOMS. SOME PEOPLE HAVE A LOT OF NASAL STUFFINESS. THERE’S A VARIETY OF DIFFERENTIS YOU CAN USE — KNOWS SPRAYS YOU CAN USE FOR THAT. EYEDROPS. THERE’S ORAL ANTIHISTAMINES. THOSE DO HAVE SIDE EFFECTS WHICH ARE SOME LIMITATIONS. THEY ARE VERY EFFECTIVE. YOU CAN DO SOME DESENSITIZATION IF YOU REALLY WANT TO. THAT’S A MORE INVOLVED PROCESS. IT GOES TO DETERMINE EXACTLY WHAT YOU ARE ALLERGIC TO AND GOING BLACK — BACK WEEKLY FOR YEARS. GETTING YOURSELF YOU SAID THAT SO YOU ARE NO LONGER REACTING TO IT AS WELL. IT DEPENDS ON WHAT YOU ARE ALLERGIC TO AND WHAT YOUR GOALS IN TREATMENT ARE AND WHAT YOU ARE WILLING TO DO. NEGOTIATE THAT WITH YOUR PRACTITIONER.>>THANK YOU. THIS IS FROM DULUTH. WHAT IS THE DIFFERENCE BETWEEN CHEMICAL AND PHYSICAL SUNSCREEN? WHICH DO YOU RECOMMEND?>>THAT’S A GREAT QUESTION. THERE’S A LOT OF DISCUSSION RIGHT NOW IN THE MEDIA AND AMONGST DERMATOLOGISTS AS TO WHAT IS BEST. PHYSICAL OR ORGANIC SUNSCREENS, ZINC TITANIUM, THEY WORK BY CREATING A RELET — REFLECTIVE BARRIER ON THE SKIN. THEY ARE NICE BECAUSE THEY BLOCK UVB, WHICH IS MOST CLEARLY RELATED TO SUNBURNS AND SKIN CANCER, BUT ALSO UVA WHICH IS RELATED TO PHOTO AGING. BROWN SPOTS, FINE LINES, WRINKLES. AS WELL AS VISIBLE LIGHT WHICH MAY HAVE ILL EFFECTS ON THE SKY. — SKIN. CHEMICAL SUNSCREENS, THE OX HE BEEN ZONE, WORK BY SITTING ON THE SKIN AND ACTUALLY TAKING RADIATION, THE UV RADIATION FROM THE SUN, AND TURNING THAT ENERGY INTO SOMETHING THAT DONE IT — DOESN’T DAMAGE THE SKIN. THERE’S A LOT OF CONCERN OUT THERE RIGHT NOW ABOUT THE SO-CALLED CHEMICAL SUNSCREENS IN THAT THEY FIND THEM IN THE BLOODSTREAM OF PATIENTS WHO HAVE APPLIED THEM TO THE SKIN. UNDERSTAND THAT THESE WERE FOUND UNDER MAC’S USE SITUATIONS WHERE PEOPLE WERE APPLYING THEM EVERY FOUR HOURS TO THEIR ENTIRE BODY FOR SEVERAL DAYS IN A ROW. THE AMOUNTS THAT THEY FOUND OF THESE CHEMICALS WERE MINISCULE. THEY HAVE NOT BEEN OUTLAWED. WHAT IS HAPPENED IS THAT THE FDA HAS ASKED MANUFACTURERS OF THESE SUNSCREENS TO SAY, IS THERE ANY HEALTH CONCERN OF HAVING THESE AMOUNTS OF CHEMICALS IN YOUR BLOODSTREAM? WE KNOW FROM DECADES OF THESE THINGS BEING USED, THERE PROBABLY ISN’T. WE WOULD HAVE LOOKED THROUGH DATA AND FOUND PROBLEMS BY THIS POINT. I PERSONALLY FOR MY PATIENCE RECOMMEND THE PHYSICAL SUNSCREENS. WE MENTIONED UP YET 30 OR HIGHER EARLIER. I GO 50. MOST PEOPLE, WHEN YOU APPLY A SUNSCREEN, YOU ONLY APPLY IT HAPPEN AS THICK AS WHAT YOU ARE SUPPOSED TO. YOU WANT TO HAVE A COMBINATION OF ZINC OR ZINC AND TITANIUM TO MAKE SURE YOU ARE BLOCKING THE FULL SPECTRUM OF RAYS FROM THE SUN.>>THANK YOU. THIS QUESTION WOULD BE FOR BOTH OF YOU. I’M NOT SURE IF IT WILL APPLY TO YOU. THIS SAYS, DO YOU TAKE COSMETIC APPOINTMENTS? I HAVE TWO PEOPLE WANT TO KNOW WHY THERE ARE SO FEW DERMATOLOGISTS. IS THERE A SHORTAGE IN DULUTH? THIS PERSON SAYS THEY HAVE TO WAIT SIX MONTHS TO SEE SOMEBODY.>>WE CERTAINLY TREAT A LOT OF PATIENTS WITH COSMETIC CONCERNS. I DO SOME LASER SURGERY. WE HAVE CERTAIN LASERS THAT WE CAN USE TO TREAT REDNESS AND DILATED BLOOD VESSELS ON THE SKIN SURFACE. A LOT OF PEOPLE HAVE THESE BARNACLE TYPE GROWTHS ON THEIR SKIN THAT THEY MIGHT WANT TO HAVE REMOVED. THEY ARE HARMLESS. WE CAN FREEZE THOSE OFF OR SURGERY REMOVE THEM. AS FAR AS THE SHORTAGE OF DERMATOLOGY PROVIDERS IN THE AREA, WE ARE WORKING ON RECRUITMENT. THE SKIN IS THE BODY’S BIGGEST ORGAN. THERE’S A LOT OF THINGS THAT CAN GO WRONG THERE. WE ARE HOPING TO IMPROVE ACCESS TO OUR SERVICES IN THE FUTURE.>>DO YOU PROVIDE COSMETIC PROCEDURES?>>WE DON’T THAT OUR CLINIC. THERE WERE SUCH A SHORTAGE OF DERMATOLOGISTS TO PROVIDE MEDICAL SERVICES. WE DECIDED WE WOULD MOVE THOSE THINGS TOWARDS THE REALM OF S THE SESSIONS AND PLASTIC SURGERY. THEY DO A FINE JOB. A COUPLE THINGS THAT I WOULD LIKE TO ADD. MAKE SURE THAT YOU UNDERSTAND THE CREDENTIALS OF THE PERSON FOR WHOM YOU ARE GOING TO RECEIVE COSMETIC SERVICES. THE ROBERT — THERE ARE A LOT OF FOLKS WHO DON’T HAVE ADEQUATE OR APPROPRIATE TRAINING THAT CAN DO PRETTY INVASIVE PROCEDURES. I DO THINK THAT YOU NEED TO UNDERSTAND WHO’S DOING WHAT TO YOU AND HOW THEY WERE TRAINED, CERTIFIED, AND CREDENTIALED. AS FAR AS THE SHORTAGE OF DERMATOLOGISTS IN DULUTH, AT ST. LUKE’S WE ARE ACTIVELY PURSUING MEANS TO INCREASE OUR EFFICIENCY IN SEEING PATIENTS THROUGH NEW COMPUTER SYSTEMS AND OTHER ARENAS SO WE CAN INCREASE PATIENT VOLUME. IT IS HARD TO RECRUIT DERMATOLOGISTS. THERE ARE A FIXED NUMBER OF PEOPLE. IT IS SOMETIMES DIFFICULT TO CONVINCE PEOPLE TO MOVE TO SOMEPLACE WHERE IT SNOWS FOR EIGHT MONTHS OUT OF THE YEAR. WE ARE WORKING AS BEST WE CAN WITH WHAT WE HAVE.>>THANK YOU. I HAVE A QUESTION FOR YOU. CAN A GENERAL PRACTITIONER FREEZE GROWTHS OFF? OUR GENERAL PRACTITIONERS QUALIFIED TO DIAGNOSE DERMATOLOGIC CONDITIONS?>>GENERAL PRACTITIONERS WORK WITHIN THEIR REALM OF COMPETENCE. THERE ARE MULTIPLE GROWTHS THAT I CAN LOOK AT AND SAY, I KNOW THAT IS. THEY ARE COMMON AND OBVIOUS. SOME OF THEM ARE FROZEN OFF EASILY. YES, I COULD DO THAT. SKIN TAGS. THEY COUNT AS COSMETIC SURGERIES. I GUESS I DO CAUSE MEDIC PROCEDURES. I CAN ALSO BIOPSY THINGS. IF THINGS NEED A BIOPSY TO GET A DIAGNOSIS, THAT IS A GOOD WAY TO GET TO THE FRONT OF THE LINE AT THE DERMATOLOGIC OFFICE. IF I BUY OPS — BY UP TO SOMETHING, YOU ARE AT THE FRONT OF THE LINE. THOSE ARE THE KINDS OF THINGS THAT YOU CAN GET DONE AT A PRIMARY CARE OFFICE.>>WE HAVE SOME RAIN QUESTIONS. I WILL THROW A COUPLE OF THEM AT YOU AT ONCE. CAN SHOULD, SHROOMS CURE DERMATOLOGIC CONDITIONS? BUMP ON ARM HAS SUNK INTO THE SKIN. WHY?>>SO, I WILL ANSWER THE BUMP ON THE ARM QUESTION FIRST. AGAIN, IT IS A VISUAL SPECIALTY. IT IS HARD TO KNOW FOR CERTAIN WHAT IS HAPPENING HERE. THERE ARE SKIN CONDITIONS WHICH CAN INVOLUTE OR SUCK IN. ONE CONDITION THAT COMES TO MIND IS SOMETHING CALLED MORPHEA. IT STARTS OUT AS A RASH WITH HARD SKIN. THE PATCH IS THE SIZE OF A DECK OF PLAYING CARDS. THEY CAN BE MINIMALLY ITCHY. THOSE CAN BECOME BOUND DOWN. ON THE ARM, ESPECIALLY OVER THE DELTOID REGION, WE SEE DERMATOFIBROMA’S. IT IS NOT A RASH. IT’S A TYPE OF SKIN GROWTH. IT IS BENIGN. THESE OCCUR FROM MINOR TRAUMA. THEY ARE OFTEN FIRM. YOU CAN TAKE YOUR FINGER AND PINCH THEM. IT WILL DOUBLE. — DIMPLE. THEY ARE AS BIG AS THE EARTH HIM AT MOST. WITH TIME, THOSE CAN SUCK IN A BIT. IT IS — IF IT IS SOMETHING THAT IS GROWING OR BLEEDING, GET THIS CHECKED OUT. I DON’T HAVE MUCH EXPERTISE WITH THOSE MUSHROOMS. THERE IS DEFINITELY A ROLE FOR NATURAL REMEDIES IN HOLISTIC MEDICINE. I ENCOURAGE PATIENTS TO EXPLORE THOSE THINGS BUT WITH CAUTION. WE DO KNOW FROM THE ESSENTIAL OIL CRAZE THAT IS GOING ON NOW, JUST BECAUSE SOMETHING IS NATURAL DOESN’T MEAN THAT IT IS SAFE. RIGHT? I ALWAYS USE THE EXAMPLE OF POISON IVY. THAT RESIN CREATES THAT HORRIBLE BLISTERING RASH THAT WE ALL KNOW . THAT IS AN ESSENTIAL OIL. IF YOU PUT ENOUGH OF A CONCENTRATION OF SOMETHING ON YOUR SKIN THAT IS NOT SUPPOSED TO BE THERE, YOU COULD HAVE A SIMILAR REACTION. IF YOU EAT THAT SOMETHING AS A SUPPLEMENT OR A PILL, YOU COULD HAVE SKIN PROBLEMS. I KNOW IN CERTAIN CULTURES, THAT MUSHROOM IS VERY POPULAR. I PERSONALLY HAVE NOT SEEN ANY ILL EFFECTS FROM THEM. I’VE NOT SEEN ANY EARTH SHATTERING IMPROVEMENTS EITHER. NOT AN EXPERT BUT THAT’S MY TWO CENTS.>>WHAT IS ROSACEA? TWO PEOPLE ARE ASKING, ARE THERE ANY NEW TREATMENTS FOR ROSACEA?>>ROSACEA IS AN INFLAMMATORY SKIN CONDITION. IT AFFECTS THE OIL GLANDS IN THE SKIN. IT CAN CAUSE REDNESS AND DILATED BLOOD VESSELS. IT CAN ALSO CAUSE RED BUMPS AND PIMPLE LIKE LESIONS. ONE OUT OF 10 PATIENTS CAN GET INCREASED OIL GLAND OVERGROWTH. WHEN THAT OCCURS, IT MIGHT CAUSE SOMETHING CALLED A RENTAL IF I’M A. YOU GET AN ENLARGED, RED NOSE. IN ONE OUT OF 10 PATIENTS, IT CAN INVOLVE THE A’S. YOU MIGHT GET DRYNESS OF YOUR EYES OR REDNESS OR IRRITATION. HOW DO WE TREAT IT? IF YOU HAVE THE PIMPLE COME — COMPONENT, WE HAVE MEDICAL MANAGEMENT WITHIN A BIOTIC — ANTIBIOTICS THAT CAN BE USED TO SUPPRESS THE REDNESS AND INFLAMMATION. WE CAN ALSO USE TOPICAL THINGS. WE FOUND OUT THAT PEOPLE WITH ROSACEA COULD BE MORE SENSITIVE TO A MIGHT THAT INHIBITS THE OIL GLANDS. THERE’S A MEDICINE THAT CAN BE USED TOPICALLY ON THE SKIN TO TREAT THE ROSACEA. FOR THE REDNESS AND BLOOD VESSELS, MEDICAL MANAGEMENT HAS NOT BEEN AS EFFECTIVE THERE. WE DO HAVE SOME TOPICALS THAT CAN BE USED ON THE SKIN TO TRY TO DECREASE SOME OF THE FACIAL FLUSHING. WE MENTIONED THE POLLS LASER THAT WE CAN USE TO TREAT SOME OF THE DILATED BLOOD VESSELS.>>LAURA AND BECKER WOULD LIKE TO KNOW HOW LONG IT TAKES FOR ALLERGY SHOTS TO WORK. KATHI WOULD LIKE TO KNOW, WHY DO I GET HIVES AFTER THEM OUTSIDE IN THE COLD WEATHER?>>HOW LONG DOES IT TAKE ALLERGY SHOTS TO WORK? IT ACTUALLY VARIES. YOU HOPE THEY WORK QUICKER. SOMETIMES THEY CAN TAKE YEARS. MY BROTHER DID THEM AND DIDN’T HAVE MUCH HELP. THEY REALLY HELPED ME. YOU CONFIGURE A COUPLE YEARS. DO EITHER OF YOU DO SHOTS?>>NO. USUALLY IN THE ALLERGY CLINICS, IMMUNOTHERAPY.>>WHY DO YOU GET HIVES? YOU CAN BE ALLERGIC TO COLD. YOU CAN.>>HERE IS THREE QUESTIONS ABOUT DRY SKINS. KATHY WANTS TO KNOW, BEST SKINCARE ROUTINE FOR DRY WEATHER? ANOTHER QUESTION IS, WHAT CAN BE DONE FOR DRY, ITCHY SKIN? AMY HAS AN ITCHY RASH ON THE TOP OF THE HANDS, NEXT TO THE THUMBS. IT HAPPNS A COUPLE OF TIMES A YEAR. THE TOPICAL STEROID CREAM IS NOT WORKING.>>VERY BROADLY SPEAKING, IN THE WINTERTIME, YOU MAY — THAT RELATIVE HUMIDITY DROPS. THERE WAS A MOISTURE IN THE AIR. YOU MIGHT NEED TO DECREASE THE FREQUENCY OF YOUR SHOWERS. I TELL PEOPLE TO USE A SELFLESS CLEANSER. — SOAP LIST — LESS CLEANSER. DON’T USE A WASH RAG OR LOOFAH. DECREASE THE TEMPERATURE IN YOUR SHOWER. SPACE IT OUT. LATHER THE SOAP IN YOUR HANDS. JUST LET THE SOAP AND WATER RINSE OFF. AS SOON AS YOU STEP OUT OF THE SHOWER, PAT DRY WITH YOUR TOWEL. DON’T RUB. APPLY A THICK MOISTURIZING CREAM. SOMETHING WHERE YOU HAVE TO SCREW THE LID OFF OF THE JAR OR SCOOP IT OUT. LOCK IN THAT MOISTURE. I THINK PROBABLY 90% OF THE DRY SKIN ISSUES WE SEE IN THE WINTER HERE CAN BE CURED WITH THOSE SIMPLE STEPS. IF THAT’S NOT WORKING, SEE ONE OF US. REGARDING THE BUMPS ON THE THUMB , IF THEY ARE CLOSE ENOUGH TO THE BASE OF THE THUMB, SOMETIMES YOU CAN GET FUNGAL INFECTIONS THAT SMOLDER. THEY ARE USUALLY MORE TENDER THAN PAINFUL. STEROIDS CAN HELP OVER TIME. SOMETIMES YOU NEED TO MIX IN ANTIFUNGAL CREAM. I’M NOT SURE THAT’S WHAT THE CALLER IS DESCRIBING. THAT MIGHT BE SOMETHING SHE MIGHT WANT TO DISCUSS WITH HER PROVIDER THAT RECOMMENDED THE STEROID CREAM IN THE PAST.>>WHAT ARE RED MOLES? WHERE DID THEY COME FROM?>>A MOLE, A TRUE MORAL, IS CAUSED BY A COLLECTION OF CELLS IN THE SKIN RELATED TO MELANOCYTES, PIGMENT CELLS. THEY CAN BECOME IRRITATED AND INFLAMED. THAT MIGHT MAKE THEM BECOME RED. A RED MOLE MIGHT ALSO BE ONE OF THESE CURIE AND YOU MUST. THOSE ARE THE MOST COMMON THING, JUST A HARMLESS COLLECTION OF BLOOD VESSELS CLOSE TO THE SKIN SURFACE. SOME PEOPLE CAN HAVE HUNDREDS OF THOSE.>>THANK YOU. THIS PERSON HERE, SEVEN YEARS AGO GOT A ROUND SCAR FROM A CAT SCRATCH. IT HAS INCREASED IN SIZE AND HAS BECOME MORE RED. SHOULD BE — SHOULD SHE BE CONCERNED?>>SEVEN YEARS AGO. A RAISED RED SCAR.>>A ROUND SCAR FROM A CAT SCRATCH. IT IS MORE RAISED AND RED.>>YOU CAN GET RAISED RED SCARS, KELOIDS. SEVEN YEARS SEEMS A BIT LONG. I SUPPOSE IT COULD HAPPEN. ESPECIALLY IF SHE IRRITATED IT OR SOMETHING. YOU DON’T EVEN HAVE TO KNOW WHAT. THAT WOULD BE MY GUESS. HAVING IT CHECKED OUT WOULD PROBABLY BE THE BEST BET.>>I THINK THE INJURY NEEDS TO MATCH THE MECHANISM OF INJURY. YOU PROBABLY SHOULD GET THAT CHECKED OUT.>>WE ARE OUT OF TIME. WE’VE HAD LOTS OF GREAT QUESTIONS. WE WANT TO THANK OUR PANELISTS. AND OUR MEDICAL STUDENT FOR VOLUNTEERS. PLEASE JOIN US NEXT WEEK FOR A PROGRAM ON DIABETES. DIAGNOSIS, COMPLICATIONS, TREATMENT. OUR PANELISTS. THANK YOU FOR WATCHING. GOOD NIGHT.


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